Bifocal Cryptococcal Osteomyelitis: Management of a Patient with Concurrent Femur and Rib Infections

Jou, Herng-Jeng; Lee, Fang-Tsai; Wang, Matthew N.; Yang, Pey-Yu; Wang, Nai-Phon

doi:10.5301/hip.2011.8579

Cited by 9 publications

(4 citation statements)

References 5 publications

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“…The outcomes of patients with disseminated cryptococcosis were unfavorable, and those of patients with or without immune abnormalities were similar; these findings differ from previous studies (Corral et al, 2011 ; Jou et al, 2011 ; Qadir et al, 2011 ; Jain et al, 2013 ). This disparity might be explained by the recent CNVG outbreak.…”

Section: Discussioncontrasting

confidence: 94%

Skeletal cryptococcosis from 1977 to 2013

Zhou

Chu

et al. 2015

Front. Microbiol.

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Skeletal cryptococcosis, an aspect of disseminated cryptococcal disease or isolated skeletal cryptococcal infection, is a rare but treatable disease. However, limited information is available regarding its clinical features, treatment, and prognosis. This systematic review examined all cases published between April 1977 and May 2013 with regard to the factors associated with this disease, including patient sex, age, and epidemiological history; affected sites; clinical symptoms; underlying diseases; laboratory tests; radiological manifestations; and delays in diagnosis, treatment, follow-up assessments, and outcomes. We found that immune abnormality is a risk factor but does not predict mortality; these observations are due to recent Cryptococcus neoformans var gattii (CNVG) outbreaks (Chaturvedi and Chaturvedi, 2011). Dissemination was irrespective of immune status and required combination therapy, and dissemination carried a worse prognosis. Therefore, a database of skeletal cryptococcosis cases should be created.

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Section: Discussioncontrasting

confidence: 94%

Skeletal cryptococcosis from 1977 to 2013

Zhou

Chu

et al. 2015

Front. Microbiol.

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“…We identified an additional 39 cases with cryptococcal osteomyelitis and the general characteristics of these patients are listed in Table . Bony involvement due to Cryptococcus species is uncommon, with an estimated prevalence of 5% and is usually seen in association with multi‐organ disseminated disease.…”

Section: Literature Review and Discussionmentioning

confidence: 99%

Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature

Medaris

Ponce

Hyde

et al. 2016

Mycoses

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Cryptococcus neoformans is a fungal pathogen associated with advanced HIV disease and other disorders associated with immune dysfunction. The pulmonary and the central nervous system are the most common manifestations of the disease. Localised osteomyelitis as the sole manifestation of extrapulmonary disease is rare. Herein, we present five cases of Cryptococcus osteomyelitis as the only manifestation of extrapulmonary disease. We also identified 84 additional cases of isolated cryptococcal osteomyelitis in the literature. Using these data, we have made some general recommendations regarding an approach to treatment of this uncommon clinical entity.

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“…The vast majority of these cases involved only one single site, and only 13 cases presented with multiple skeletal lesions [ 6 , 15 , 17 , 31 , 33 , 36 , 37 , 39 , 44 – 46 , 58 , 78 ]. Cases that reported cryptococcal osteomyelitis in pediatric patients were excluded.…”

Section: Review Of the Literaturementioning

confidence: 99%

Cryptococcus neoformans osteomyelitis of the tibia: a case report and review of the literature

et al. 2023

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Introduction Osteomyelitis is a bone inflammation that can be related to various infectious agents. As with any other type of inflammation, the prevailing symptoms and signs may include redness, swelling, pain, and heat. Fungal osteomyelitis is rare and usually found in immune-compromised patients. Case presentation A non-human immunodeficiency virus immunocompromised Greek female patient, 82 years old, visited the emergency department due to a 3 day pain located mainly over the left tibia’s anterior surface, accompanied by swelling and redness. There was also a subcutaneous lesion of her left breast. Medical history revealed that the patient had an unmasked close contact with pigeons, a main host of the disease. Initial x-ray imaging showed an osteolytic area in the upper third of the tibial diaphysis. The patient was admitted and underwent a computed tomography-guided biopsy. The specimen revealed a Cryptococcus neoformans infection of the bone and the breast. She was treated with 400 mg fluconazole twice a day for 3 weeks while in hospital and 200 mg twice a day upon discharge for 9 months. After that, she underwent surgical debridement because of lasting local irritation. She was closely monitored in our outpatient office, and in her last visit, 1 year after the initial admission, inflammatory signs had regressed vastly. Conclusions To our knowledge, this is the ninth cryptococcal osteomyelitis of the tibia to be recorded since 1974, and the most unusual finding was the bifocal nature of the infection, affecting both the tibia and the breast.

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Bifocal Cryptococcal Osteomyelitis: Management of a Patient with Concurrent Femur and Rib Infections

Cited by 9 publications

References 5 publications

Skeletal cryptococcosis from 1977 to 2013

Skeletal cryptococcosis from 1977 to 2013

Cryptococcal osteomyelitis: a report of 5 cases and a review of the recent literature

Cryptococcus neoformans osteomyelitis of the tibia: a case report and review of the literature

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